Tishomingo Comm Living Center

In the surveyor’s words

From the most serious findings on record at Tishomingo Comm Living Center, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Dec 18, 2025

  Based on observation, interviews, record review and facility policy review, the facility failed to provide adequate supervision and a secure environment to prevent the elopement of one (1) of five (5) residents who were at risk for elopement and wandering, Resident #68.On 12/10/25, at approximately 2:53 PM a member of the facility staff reported in the staff meeting that Resident #68 was found inside the pharmacy across the street. At 2:55 PM Resident # 68 was located by facility staff, approximately 100 yards away from the facility across a busy two-lane street inside the pharmacy where he was observed standing, laughing and conversing with the pharmacy staff. […]

• Immediate jeopardy, isolatedF655Jun 1, 2023

  Based on interview, facility and hospital record review, and facility policy review the facility failed to ensure a baseline careplan was developed for a resident with Diabetes resulting in death for one (1) of six (6) resident records reviewed; Resident #1. During the survey, the SA identified an Immediate Jeopardy (IJ) and Substandard Quality of Care (SQC) which began on [DATE], when the facility failed to accurately transcribe physician's orders, reconcile, and verify physician's orders resulting in the omission of an insulin order. Resident #1's physician ordered long-acting insulin was not administered for five days following admission on [DATE] at approximately 4:49 PM, and the resident had to be transferred to the emergency roiagnom on [DATE] at 5:10 AM. […]

• Immediate jeopardy, isolatedF658Jun 1, 2023

  Based on interviews, facility and hospital record review, and facility policy review, the facility failed to provide services to meet professional standards by failing to ensure the accuracy and reconciliation of a resident's physician orders for medications for a resident with Diabetes resulting in death for one (1) of six (6) resident records reviewed; Resident #1. During the survey, the SA identified an Immediate Jeopardy (IJ) and Substandard Quality of Care (SQC) which began on [DATE], when the facility failed to accurately transcribe physician's orders, reconcile, and verify physician's orders resulting in the omission of an insulin order. […]

• Immediate jeopardy, isolatedF684Jun 1, 2023

  Based on staff interviews, record review and facility policy review the facility failed to ensure each resident received the necessary care and services in accordance with professional standards of practice to meet each resident's physical needs for one (1) of 10 residents reviewed (six (6) sampled residents and four (4) unsampled residents). Resident #1 During the survey, the SA identified an Immediate Jeopardy (IJ) and Substandard Quality of Care (SQC) which began on [DATE], when the facility failed to accurately transcribe physician's orders, reconcile, and verify physician's orders resulting in the omission of an insulin order. […]

• Immediate jeopardy, isolatedF760Jun 1, 2023

  Based on staff interview, record review and facility policy review the facility failed to ensure a resident was free from significant medication errors as evidenced by insulin being omitted from a resident's record for one (1) of six (6) medication orders reviewed. Resident #1 During the survey, the SA identified an Immediate Jeopardy (IJ) and Substandard Quality of Care (SQC) which began on [DATE], when the facility failed to accurately transcribe physician's orders, reconcile, and verify physician's orders resulting in the omission of an insulin order. Resident #1's physician ordered long-acting insulin was not administered for five days following admission on [DATE] at approximately 4:49 PM, and the resident had to be transferred to the emergency roiagnom on [DATE] at 5:10 AM. […]